POST 00915E : VACCINE WASTAGE

POST 00915E : VACCINE WASTAGE Follow-up on Posts 00889E, 00894E, 00899E, 00906E and 00910E 22 April 2006 ________________________________________________________________ This posting contains three contributions. The first is from Bibata Pare (mailto:[email protected]) from Burkina Faso. The second is from Amir Ansari (mailto:[email protected]) from Tajikistan. They both comment on Sridharan’s suggestion of promoting the use of Uniject®. And the third is from Anil Varshney (mailto:[email protected]) from India, who discusses both Sridharan’s suggestion and Anthony’s contribution in Post 00906E. He rightly raises the issue of storage space. ____________________________________ Dear friends, The idea suggested by Sridharan might be the best solution for reducing vaccines wastages. It would be excellent indeed, if there could be on the market single dose packaging, not only for HepB vaccine, but for all EPI antigens!!! The paradox however is that presently, many countries are making a lot of efforts to contribute to financing their own vaccines! Some even managed to become self-sufficient, with the exception of course for new vaccines! At what costs then could firms offer "single dose" vaccines to countries most of which are, let’s not forget, heavily indebted poor countries? If we could only dream of it!!! Instead UNICEF and WHO could help countries put in place good vaccine management systems. WHO has already taken steps in that direction with the implementation of vaccines management performance tools. Their use though is seriously challenged by lack of training! We could certainly reduce system- related wastages, which are undoubtedly current in many countries and represent at least 70% of all vaccines wastages! Mrs. PARE Bibata Logistics / Burkina Faso ---------------------------- Dear Sridharan Thanks for sharing this info. I believe in addition to addressing vaccine wastage, Uniject® could improve and increase coverage of Hep-B birth dose especially in countries where home delivery is high due to access and utilization challenges. Best regards, Amir Ansari, MD Health Section UNICEF Tajikistan ----------------------------- Hello, The vaccine wastage in HBV in Nigeria was expected as the program management did not look at the DTP 3 coverage which was very low so high wastages in DTP 3. Hence there will be high wastage in HBV ; also no efforts to reduce wastages in programme. The wastage in program could also have been reduced by trainining in logistics - procurement. When ordering for vaccines most national program managers order for the 100% coverage, 1.33 as wastage factor and 25 % as buffer at each storage space which adds to excess stocks losses and wastages. The stock positions at various depot at PHC, district, regional stores is hardly taken into account. Stocks at these stores plus national stores should be considered as stocks in hand. Further distribution from national to state to regional to districts to PHCs is not based on population but on fixed number of boxes to be supplied and not vials in case of DTP or other vaccines and the same logic is followed for HBV. I had undertaken the vaccine logistics study for Andhra Pradesh/PATH program prior to introduction of HBV ( this was one of the most extensive study). It will be a good exercise to see if there is improvement in vaccine use / wastages in the same distritcs/ other distritcs after HBV was introduced and training was imparted in these districts under PATH. The outcome could be an useful learning for other countries and states. I did advocate use of multi-dose vials instead of Uniject® after calculating the additional volumes needed for storage at each level and possible wastages already in place and comparing them for Uniject® and multidose vials cost. In the case of Nigeria as Chari says savings would have been possible. This would have been achieved only if the Uniject® was purchased/procured in at national level or purchased in yearly demand with very long expiration say more than 2 years ideally 4 years to compensate for the wastage, as wastage was more than 80%. The wastages with Uniject® could be reduced if procurement was linked to monthly or quarterly/half-yearly consumption reports which usually does not take place at national level as is based on yearly demand generation given to UNICEF with time frame for deliveries and no possibility of corrections and reductions based on consumption or wastages. Futher no supplier will agree to reduce volumes once order has been placed. Wastages in Uniject® would be nil if only quantities as calculated based on actual children immunized not equal to DTP vaccine dose. When a new vaccine is introduced it will only be from the end of 2nd year that the actual consumption pattern would be useful since process of procurement for 2nd year starts 6 months after first year procurement has begun. Regards, Dr Anil Varshney ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : mailto:[email protected] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. 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